Continuity of care: A Nursing Needs Assessment Instrument

Based on testing of the Uniform Needs Assessment Instrument (UNAI), a nursing needs assessment tool for adult hospitalized patients was integrated into nursing practice. Some content and format changes to the UNAI occurred as a result of the research process. The revised assessment form is called the Nursing Needs Assessment Instrument (NNAI). Community providers, including nursing home and home health care personnel, use the NNAI to derive necessary admission data for assessing patients, planning care, and communicating with other staff regarding patient needs. Instituting an evidence-based practice change in hospital discharge forms enables the next care provider to consistently meet the patient's continuing needs. (Geriatr Nurs 1998:19:331-4)     

Anxiety and Depression in Ethnic Minorities With Chronic Heart Failure

BackgroundConsiderable evidence confirms the high prevalence of anxiety and depression in the patients with heart failure (HF). However, little is known about the relationship of race/ethnicity to psychosocial variables in this population. The purpose of this study was to examine and compare the incidence of anxiety and depression in a cohort of non-Hispanic blacks, Hispanics, and non-Hispanic whites with advanced systolic HF.Methods and ResultsTwo-hundred forty-one patients (7% non-Hispanic blacks, 22.8% Hispanics, 60.7% non-Hispanic whites) mean age 56.7 ± 13.0 years, male (70%), married (81%), retired (75%), New York Heart Association (NYHA) Class III (53.9%), and mean ejection fraction 31.2 ± 5.4%) from a single heart transplant facility were asked to complete a series of questionnaires to assess anxiety, depression, perceived control, social support, and financial stability. Non-Hispanic blacks had higher levels of anxiety (P = .048) and depression (P = .026) compared with Hispanics; a similar trend was noted when comparing non-Hispanic blacks and non-Hispanic whites, but these differences were not statistically significant. Perceived control was highest among Hispanics and lowest among non-Hispanic whites (P = .046). In a multivariate model race/ethnicity, perceived control, and social support accounted for 30% of the variance in anxiety while race/ethnicity, NYHA Class, perceived control, and social support accounted for 41% of the variance in depression.ConclusionsOur findings reveal that non-Hispanic blacks are more likely to be anxious and depressed than their counterparts. Because patient perceptions of control and social support are related to dysphorias known to influence morbidity and mortality, clinicians should regularly assess patients' concerns and assist in accessing appropriate services and treatments tailored to individual needs. Non-Hispanic blacks warrant increased scrutiny.     

Risk‐taking behavior among native American adolescents in Minnesota public schools: Comparisons with black and white adolescents

Objectives. To examine rates of risk‐taking behavior among native American adolescents in comparison with blacks and whites, and then to compare our off‐reservation native American sample to available national statistics on reservation youth.

Methods. A secondary data analysis of a Minnesota public school health survey. Contingency table analyses were performed on a 10% random sample of over 6000 young people focussing on three categories of behavioral risk: antisocial behavior, sexual behavior and substance use. Comparisons were then made to a national convenience sample from reservations and adjacent rural areas.

Results. In general, native American adolescents have a significantly higher prevalence of risk behaviors across all indices of antisocial behavior and substance use relative to white and black peers. Native American females presented the most troubling picture. Comparisons to a national convenience sample from reservation lands indicated that native American adolescents in the sample often exceeded national rates of risk behavior.

Conclusions. Residence and attendance at public schools outside reservation lands may make native American adolescents more likely to engage in risky behaviors which endanger their health.     

Occupational X-ray Exposure

A change in the rubidium chloride Rb 86 red blood cell kinetics may reflect the effect of low levels of radiation upon the bone marrow. In workers in radiology who received x-ray exposure considered to be of acceptable levels, the uptake of ⁸⁶Rb by the erythrocytes was greater than in those receiving no measurable occupational exposure. Uptake was greatest at multiples of two to three times natural background and was greater in those persons with fewer than ten years of occupational exposure.